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- Volume 29, Issue 15, 11/Apr/2024
Eurosurveillance - Volume 29, Issue 15, 11 April 2024
Volume 29, Issue 15, 2024
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Excess mortality in Europe coincides with peaks of COVID-19, influenza and respiratory syncytial virus (RSV), November 2023 to February 2024
Sarah K Nørgaard , Jens Nielsen , Anne Christine Nordholm , Lukas Richter , Alena Chalupka , Natalia Bustos Sierra , Toon Braeye , Maria Athanasiadou , Theodore Lytras , Gleb Denissov , Oskari Luomala , Anne Fouillet , Isabelle Pontais , Matthias an der Heiden , Benedikt Zacher , Alina Weigel , Ivo Foppa , Kassiani Gkolfinopoulou , Ioannis Panagoulias , Anna Paldy , Tibor Malnasi , Lisa Domegan , Eva Kelly , Naama Rotem , Oksana Rakhlin , Francesca K de'Donato , Chiara Di Blasi , Patrick Hoffmann , Telma Velez , Kathleen England , Neville Calleja , Liselotte van Asten , Femke Jongenotter , Ana Paula Rodrigues , Susana Silva , Petra Klepac , Diana Gomez-Barroso , Inmaculada Leon Gomez , Ilias Galanis , Ahmed Farah , Rolf Weitkunat , Katarina Fehst , Nick Andrews , Tom Clare , Declan T Bradley , Mark G O'Doherty , Naoma William , Mark Hamilton , Bolette Søborg , Tyra G Krause , Nick Bundle and Lasse S VestergaardSince the end of November 2023, the European Mortality Monitoring Network (EuroMOMO) has observed excess mortality in Europe. During weeks 48 2023–6 2024, preliminary results show a substantially increased rate of 95.3 (95% CI: 91.7–98.9) excess all-cause deaths per 100,000 person-years for all ages. This excess mortality is seen in adults aged 45 years and older, and coincides with widespread presence of COVID-19, influenza and respiratory syncytial virus (RSV) observed in many European countries during the 2023/24 winter season.
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Emergence of OXA-48-like producing Citrobacter species, Germany, 2011 to 2022
BackgroundCarbapenemase-producing Enterobacterales are a public health threat worldwide and OXA-48 is the most prevalent carbapenemase in Germany and western Europe. However, the molecular epidemiology of OXA-48 in species other than Escherichia coli and Klebsiella pneumoniae remains poorly understood.
AimTo analyse the molecular epidemiology of OXA-48 and OXA-48-like carbapenemases in Citrobacter species (spp.) in Germany between 2011 and 2022.
MethodsData of 26,822 Enterobacterales isolates sent to the National Reference Centre (NRC) for Gram-negative bacteria were evaluated. Ninety-one Citrobacter isolates from 40 German hospitals harbouring blaOXA-48/OXA-48‑like were analysed by whole genome sequencing and conjugation experiments.
ResultsThe frequency of OXA-48 in Citrobacter freundii (CF) has increased steadily since 2011 and is now the most prevalent carbapenemase in this species in Germany. Among 91 in-depth analysed Citrobacter spp. isolates, CF (n = 73) and C. koseri (n = 8) were the most common species and OXA-48 was the most common variant (n = 77), followed by OXA-162 (n = 11) and OXA‑181 (n = 3). Forty percent of the isolates belonged to only two sequence types (ST19 and ST22), while most other STs were singletons. The plasmids harbouring blaOXA‑48 and blaOXA-162 belonged to the plasmid types IncL (n = 85) or IncF (n = 3), and plasmids harbouring blaOXA‑181 to IncX3 (n = 3). Three IncL plasmid clusters (57/85 IncL plasmids) were identified, which were highly transferable in contrast to sporadic plasmids.
ConclusionIn CF in Germany, OXA-48 is the predominant carbapenemase. Dissemination is likely due to distinct highly transmissible plasmids harbouring blaOXA‑48 or blaOXA-48-like and the spread of the high-risk clonal lineages ST19 and ST22.
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Epidemiology, resistance genomics and susceptibility of Acinetobacter species: results from the 2020 Spanish nationwide surveillance study
BackgroundAs increasing antibiotic resistance in Acinetobacter baumannii poses a global healthcare challenge, understanding its evolution is crucial for effective control strategies.
AimWe aimed to evaluate the epidemiology, antimicrobial susceptibility and main resistance mechanisms of Acinetobacter spp. in Spain in 2020, and to explore temporal trends of A. baumannii.
MethodsWe collected 199 single-patient Acinetobacter spp. clinical isolates in 2020 from 18 Spanish tertiary hospitals. Minimum inhibitory concentrations (MICs) for nine antimicrobials were determined. Short-read sequencing was performed for all isolates, and targeted long-read sequencing for A. baumannii. Resistance mechanisms, phylogenetics and clonality were assessed. Findings on resistance rates and infection types were compared with data from 2000 and 2010.
ResultsCefiderocol and colistin exhibited the highest activity against A. baumannii, although colistin susceptibility has significantly declined over 2 decades. A. non-baumannii strains were highly susceptible to most tested antibiotics. Of the A. baumannii isolates, 47.5% (56/118) were multidrug-resistant (MDR). Phylogeny and clonal relationship analysis of A. baumannii revealed five prevalent international clones, notably IC2 (ST2, n = 52; ST745, n = 4) and IC1 (ST1, n = 14), and some episodes of clonal dissemination. Genes blaOXA-23, blaOXA-58 and blaOXA-24/40 were identified in 49 (41.5%), eight (6.8%) and one (0.8%) A. baumannii isolates, respectively. ISAba1 was found upstream of the gene (a blaOXA-51-like) in 10 isolates.
ConclusionsThe emergence of OXA-23-producing ST1 and ST2, the predominant MDR lineages, shows a pivotal shift in carbapenem-resistant A. baumannii (CRAB) epidemiology in Spain. Coupled with increased colistin resistance, these changes underscore notable alterations in regional antimicrobial resistance dynamics.
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Volumes & issues
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Volume 29 (2024)
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Volume 28 (2023)
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Volume 27 (2022)
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Volume 26 (2021)
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Volume 25 (2020)
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Volume 24 (2019)
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Volume 23 (2018)
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Volume 22 (2017)
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Volume 21 (2016)
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Volume 20 (2015)
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Volume 19 (2014)
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Volume 18 (2013)
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Volume 17 (2012)
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Volume 16 (2011)
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Volume 15 (2010)
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Volume 14 (2009)
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Volume 13 (2008)
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Volume 12 (2007)
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Volume 11 (2006)
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Volume 10 (2005)
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Volume 9 (2004)
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Volume 8 (2003)
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Volume 7 (2002)
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Volume 6 (2001)
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Volume 5 (2000)
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Volume 4 (1999)
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Volume 3 (1998)
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Volume 2 (1997)
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Volume 1 (1996)
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Volume 0 (1995)
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